Plan A ($750 Deductible, $2,500 Out of Pocket Max ; 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$1,245.48 |
$1,033.19 |
$212.29 |
| Employee & Spouse |
$2,600.28 |
$1,442.13 |
$1,158.15 |
| Employee & Children |
$2,224.24 |
$1,386.40 |
$837.84 |
| Family |
$3,385.73 |
$1,598.53 |
$1,787.20 |
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$968.79 |
$1,024.34 |
($55.55)* |
| Employee & Spouse |
$2,022.63 |
$1,442.13 |
$580.49 |
| Employee & Children |
$1,730.08 |
$1,386.40 |
$343.68 |
| Family |
$2,633.60 |
$1,598.53 |
$1,035.07 |
* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).
Plan C (H.S.A.) ($3,000/$3,400 Deductible, $5,000 Out of Pocket Max: 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$877.19 |
$1,000.10 |
($122.91)* |
| Employee & Spouse |
$1,831.37 |
$1,436.09 |
$395.28 |
| Employee & Children |
$1,566.52 |
$1,373.13 |
$193.39 |
| Family |
$2,384.59 |
$1,598.54 |
$786.05 |
* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).
H.S.A Participants – The University will contribute $111.11/month to an H.S.A. account for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.
Plan A ($750 Deductible, $2,500 Out of Pocket Max ; 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$1,245.48 |
$1,000.99 |
$244.49 |
| Employee & Spouse |
$2,600.28 |
$1,409.93 |
$1,190.35 |
| Employee & Children |
$2,224.24 |
$1,354.20 |
$870.04 |
| Family |
$3,385.73 |
$1,566.33 |
$1,819.40 |
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$968.79 |
$996.56 |
($27.77)* |
| Employee & Spouse |
$2,022.63 |
$1,409.93 |
$612.69 |
| Employee & Children |
$1,730.08 |
$1,354.20 |
$375.88 |
| Family |
$2,633.60 |
$1,566.33 |
$1,067.27 |
* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).
Plan C (H.S.A.) ($3,000/$3,400 Deductible, $5,000 Out of Pocket Max: 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$877.19 |
$972.32 |
($95.13)* |
| Employee & Spouse |
$1,831.37 |
$1,405.60 |
$425.77 |
| Employee & Children |
$1,566.52 |
$1,342.64 |
$223.88 |
| Family |
$2,384.59 |
$1,566.34 |
$818.25 |
* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).
H.S.A Participants – The University will contribute $111.11/month to an H.S.A. account for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.
Plan A ($750 Deductible, $2,500 Out of Pocket Max ; 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$1,245.48 |
$968.79 |
$276.69 |
| Employee & Spouse |
$2,600.28 |
$1,377.72 |
$1,222.56 |
| Employee & Children |
$2,224.24 |
$1,322.00 |
$902.24 |
| Family |
$3,385.73 |
$1,534.13 |
$1,851.60 |
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$968.79 |
$968.79 |
$0 |
| Employee & Spouse |
$2,022.63 |
$1,377.72 |
$644.91 |
| Employee & Children |
$1,730.08 |
$1,322.00 |
$408.08 |
| Family |
$2,633.60 |
$1,534.13 |
$1,099.47 |
Plan C (H.S.A.) ($3,000/$3,400 Deductible, $5,000 Out of Pocket Max: 2x Family)
| Coverage |
Total Premium |
University Contribution |
Employee Contribution |
| Employee Only |
$877.19 |
$944.55 |
($67.36)* |
| Employee & Spouse |
$1,831.37 |
$1,375.09 |
$456.28 |
| Employee & Children |
$1,566.52 |
$1,312.15 |
$254.37 |
| Family |
$2,384.59 |
$1,534.14 |
$850.45 |
* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).
H.S.A Participants – The University will contribute $111.11/month to an H.S.A. account for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.